SmartHealth Advantage
The SmartHealth Advantage Plan provides you and your family with an affordable and reliable comprehensive medical care benefit for major health needs such as hospitalization, surgery, cancer treatment, diagnostic labs, and imaging, and maternity.These comprehensive medical benefits are facilitated through a medical share plan which provides both lower out-of-pocket expense as well as lower monthly costs.
Additionally, the SmartHealth Advantage Plan includes all of the benefits contained in both the SmartHealth Basic and SmartHealth Plus plans.
Plans start at just $329.00/month for groups and $379.00/month for individuals.
SHC Plus Plan Highlights
No network requirement for comprehensive care benefits
Initial Unshareable Amount: $1000 or $2500 IUA – max. per plan. 3 IUAs per 12 month period from date of 1st IUA
Inpatient Benefits
- Hospital Confinement - initial admission and continued stay
- ICU & sub-acute ICU
- Surgery & Anesthesia
- Rehabilitation Unit (not drug or alcohol related)
- Labs & Diagnostic Imaging (diagnostic lab tests, x-ray, mri, ct, pet, eeg, gastroenterology)
- Physician & Specialist visits
- Emergency Room
Outpatient Benefits
- Surgery & Anesthesia (includes. Physician & facility fees)
- Rehabilitation Physical Therapy (not drug or alcohol related)
- Labs & Diagnostic Imaging (diagnostic lab tests, x-ray, mri, ct, pet, eeg, gastroenterology)
- Physician & Specialist visits
- Emergency Room
Maternity Benefits
- Maternity (includes physician visits, delivery, surgery, hospital stay)
- Emergency Room
- NICU & sub-acute NICU
End of Life Benefit
- Primary or spouse: $10,000
- Child: $2500
Outpatient Doctor Visits
IN-NETWORK - Multiplan PHCS
$25 co-pay for all outpatient physician office visits at primary care physician office, specialist, urgent care, or retail medical clinic. Plan pays up to $200 for services rendered per visit after co-pay. Max. benefit 4 or 6 visits per insured/year OUT-OF-NETWORK
$25 co-pay for all outpatient physician office visits at primary care physician office, specialist, urgent care, or retail medical clinic. Plan pays up to 125% of Medicare for services rendered per visit after co-pay. Max. benefit 4 or 6 visits per insured/year
Annual Wellness Exam
IN-NETWORK - Multiplan PHCS
No cost for all covered wellness and preventive care services. Max. benefit: 1 exam per year per insured History, Physical Exam, Measurements (height, weight, body mass index). OUT-OF-NETWORK: Not covered.
Preventive Care for Adults
Abdominal Aortic Aneurysm Screening - One-time screening for age 65-75
Blood Pressure screening - One-time per plan year
Cholesterol screening - One-time per plan year
Type 2 Diabetes screening - One-time per plan year
Hepatitis B screening for adults at high risk - One-time per plan year
Hepatitis C screening for adults at high risk - One-time per plan year
HIV screening & counseling - One-time per plan year
Immunization vaccines One-time per plan year per immunization (EACH) - hepatitis A & B, herpes zoster, human papillomavirus, influenza (flu shot), measles, mumps, rubella, meningococcal, pneumococcal, tetanus, diphtheria, pertussis, and varicella
Obesity screening & counseling - One-time per plan year
Sexually Transmitted Infection (STI) prevention counseling - One-time per plan year
Syphilis screening - One-time per plan year
Preventive Care for Women
BRCA counseling and genetic testing - One-time per plan year for Women at higher risk
Breast Cancer Mammography Screenings - One-time per plan year for women age 40+
Breast Cancer Chemo prevention counseling - One-time per plan year
Cervical Cancer screening - One-time per plan year
Gestational Diabetes screening - One-time per plan year
Hepatitis B screening - One-time per plan year
HIV screening & counseling - One-time per plan year
Human Papillomavirus (HPV) DNA test - One-time every 3 years for women with normal cytology age 30+
Osteoporosis screening - One-time per plan year for women age 60+
Well-woman visits - To obtain recommended preventive services
Preventive Care for Children
Immunization vaccines One-time per plan year per immunization (EACH) - hepatitis A & B, herpes zoster, human papillomavirus, influenza (flu shot), measles, mumps, rubella, meningococcal, pneumococcal, tetanus, diphtheria, pertussis, and varicella
Autism screening - Limited to 2 screenings up to age 26 months
Blood Pressure screening - One-time per plan year
Congenital Hypothyroidism screening - One-time per plan year for Newborns up to age 3 months
Phenylketonuria (PKU) screening - One-time per plan year for Newborns up to age 3 months
Sexually Transmitted Infection (STI) prevention counseling & screening - One-time per plan year for adolescents aged 12 to 17 years
Tuberculin testing - One-time per plan year
Vision screening - One-time per plan year for children up to age 5
Virtual Primary Care
Every subscriber is assigned a primary care provider to support overall health and wellness as well as management of chronic medical conditions and the coordination of care with local medical providers (i.e., specialists).
Virtual Urgent Care
For immediate diagnosis, treatment, or direction of acute medical conditions.
Virtual Basic Mental Health
Preliminary diagnosis, counseling, and treatment and/or referrals to local mental health specialists as appropriate.
Patient Concierge Service
We first diagnose and treat all that is responsible to handle virtually and then guide our members to the highest value, lowest cost providers and resources in their geographic area, including prescriptions, local labs, imaging, and other diagnostic services.
Health & Wellness Coaching
Weight loss, smoking cessation, and overall lifestyle coaching and support.
Pre & Post Natal Support
Consultation with our maternal and fetal medicine specialists, advice, guidance, lactation consults and more.
Digital Tools
We support the patient empowerment journey through online education, research tools, a medical grade symptom checker, and much more.
Prescriptions
Comprehensive formulary with over 2000 medications. 200+ of the most commonly prescribe medications for $1. Accepted at over 70,000 participating pharmacies. Includes direct mail order delivery, international pharmacy access, prescription assistance program, pet medications, and discounted diabetic supplies. See Basic Rx Benefit Overview for details.
Lab Tests & Screening
Thousands of at-home diagnostic lab tests and screening tests direct to you. Results delivered through our secure patient portal. Share and discuss your results with your Virtual Primary Care Physician.
Ready To Get Started?
Give Us A Call (689) 999 - 0001
When you're ready to start saving on your healthcare benefits, our benefit counselors are here to help.
Simply give us a call or click the link to schedule an appointment at your convenience. Schedule An Appointment
The SmartHealth Company works exclusively with small business groups, sole proprietors, and independent contractors to provide them with affordable and accessible health benefits to give them a competitive advantage in the work marketplace to retain and attract the quality talent needed to help make their businesses succeed.
